Friday, September 02, 2005

Returning Home
Treatment for veterans suffering from PTSD must be factored into the cost of war.

Five decorated combat veterans from Bayou Blue could change the way we look at the war in Iraq and mental health care in the United States. They took the first step last week. In our Feb. 15 cover story, "The Hidden Wounds of War," all five men discussed publicly for the first time their harrowing memories from wars in Iraq, Afghanistan and Vietnam, and the difficulties they've experienced adjusting to life after warfare.

Four of the five veterans have been diagnosed with post-traumatic stress disorder (PTSD), a potentially disabling psychiatric condition that can result from experiencing a life-threatening event such as combat. They said that the federal government is not doing enough to alert returning troops to the dangers -- including anger, rage, emotional numbing, recurring nightmares and flashbacks of wartime traumas -- of untreated PTSD. These veterans don't like to tell war stories. But by going public, they hope to encourage soldiers now returning from Iraq to get confidential testing for PTSD at the Veterans Administration (VA) hospital in New Orleans.

The four men diagnosed with PTSD who were interviewed by Gambit Weekly are Marty Chaisson, 30, a former Marine Corps staff sergeant who led combat platoons in both Iraq and Afghanistan; his father, James Chaisson, 57, a specialist and crew chief in the Army Air Cavalry in Vietnam; William "Bill" Runnels, 58, a naval gunner's mate in Vietnam; and Loyd Olin, 61, a specialist and crew chief in the Army Aviation Division during Vietnam. The fifth veteran, Marine Cpl. Miguel Perez, 22, has not been diagnosed with PTSD. He is recovering from an enemy bullet wound suffered in Iraq that may preclude his return to combat.

The four "PTSD vets" are members of the Forgotten Warriors, Houma Chapter 2, a small veterans' organization. Chapter representatives made a presentation to Vice President Dick Cheney during his Dec. 1 visit to Houma for a political fundraiser, and the group takes a special pride in helping homeless veterans. All five veterans may never engage a foreign enemy in battle again, but their courageous outreach efforts exemplify the kind of leadership our country needs if we hope to provide adequate mental health care to returning U.S. troops.

On March 25, 2004, Dr. James Scully, medical director of the American Psychiatric Association, reported a 42 percent increase in VA patients with severe PTSD. More than half a million vets now use the VA for psychological help. But even those high numbers might not tell the whole story. The New England Journal of Medicine recently published the results of a study conducted by a team of Army psychiatrists that showed that one out of every six combat soldiers returning from Iraq in 2003 met criteria for "major depression, generalized anxiety disorder, or PTSD." Yet social stigmatization stopped many from seeking help. "Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care," the study reported. The figure was even worse for military personnel with PTSD symptoms alone -- only 4.1 percent sought treatment. "[T]hose returning from Operation Iraqi Freedom or Operation Enduring Freedom who reported the greatest number or the most severe symptoms were the least likely to seek treatment for fear it could harm their careers, cause difficulties with their peers and with unit leadership, and become an embarrassment in that they would be seen as Œweak,'" psychiatrist Matthew J. Friedman commented in a Journal article titled "Acknowledging the Psychiatric Cost of War."

Reducing the stigma of mental health care should be a priority, the study concludes. We agree. Department of Defense spokesperson Jim Turner told us that PTSD cases presently are not recorded in casualty counts from Iraq and Afghanistan. "We don't have a trauma registry," Turner says. That should change soon, because Defense is expanding its post-deployment health assessment program to include PTSD. More than 600,000 service members will be required to visit a health care provider within three to six months after re-redeployment. All active, Guard and Reserve forces are required to comply with the new directive.

Still, many experts are concerned that the country is not prepared to help returning troops. The VA currently projects a $1.65 billion shortfall in mental health programs by the end of 2007. "If we don't give the VA what it needs immediately, the consequences will be lifelong and devastating," says Steve Robinson, executive director of the National Gulf War Resource Center. Treatment for our returning veterans must be factored into the cost of war. It should be the first concern of anyone who supports our troops. We applaud those who served overseas and who are serving again by coming forward with their stories of PTSD. So does Madeline Uddo, outpatient program manager of the VA's PTSD Clinic in New Orleans. "It certainly will be helpful in terms of encouraging veterans to come in for treatment," Uddo says. By hearing other soldiers' stories -- and by encountering a VA program fully funded and prepared to help them -- our veterans with hidden wounds might finally be able to return home.